Rosenhan STUDY 1

Aim
To test reliability and validity of diagnostic system
To see if psychiatrists could can tell the difference between those who are sane and insane.

What method did Rosenhan claim it was?
Field experiment
He claimed the IV was the words that the pseudo patients could hear.

What was the actual method?
Covert participant observation
Rosenhan and his confederates were pretending to be insane to gain admittance to hospitals.
Then they observed the behaviour of staff and participants without them knowing.

Participants
Staff and patients of 12 hospitals from 5 different states in the USA
Public and private hospitals

Pseudopatients
These are not the participants
8 fake patients- Rosenhan and his confederates
No history of mental illness
5 males, 3 females
All used a fake name

Procedure
All 8 pseudo-patients were admitted
11 diagnosed with schizophrenia and 1 with manic depressive psychosis (bi-polar depression)
12 HOSPITALS WERE USED WITH 8 PSEUDO-PATIENTS AS SOME WENT TO MORE THAN ONE HOSPITAL

Once admitted they stopped showing signs of abnormality and started behaving ad they normally would.
They were told to convince staff that they were better and could be released.

They made notes of everything and began taking them in public places as ‘no-one seemed to care’.
They obeyed all instructions but did not take the medication (hiding it) but staff believed they were.

None of the patients were detected as fake- failure in diagnostic system.

Some actual patients were suspicious- 35 out of 118 patients voiced suspicions ‘you’re not crazy, you’re a journalist’

They were all eventually discharged with ‘schizophrenia in remission’

What did the pseudo patients record?
Responses to patients when they made requests
Minutes staff spent with patients
Number of times staff left the ‘cage’ (office)
Amount of eye contact from psychiatrists
How patients were treated- diaries

Percentage of avoided eye contact by psychiatrists
71%

Number of responses made to requests
13 out of 185 requests (7%)

Amount of time spent with psychiatrists
Less than 7 mins a day

Number of pills
2100

What was the overall experience like?
Not a caring one
Extremely unpleasant
Felt a sense of powerlessness and depersonalistaion

Evidence to support powerlessness?
Lack of personal privacy
e.g. hygiene and waste evacuation monitored and toilets had no doors

Evidence to support depersonalisation?
Patients ignored by staff- they moved their head, avoided eye contact

Verbal and psychical abuse to patients
e.g. ‘come on you mother****ers, out of bed’

Evidence for staff seeing normal behaviour a symptom for mental illness
Writing in a journal – engages in excessive writing behaviour’

Queueing for lunch- oral acquisitive behaviour (eager)

Conclusion
Diagnostic system is unreliable- doctors could not tell who was sane and insane.

More likely to diagnose a healthy person as sick or a sick person as healthy- TYPE ONE ERROR

Better and safer to do this and misdiagnose rather than do nothing?

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